New GOP Health Plan Is White Flag in Obamacare Repeal Fight

A blog about business and economics.
Jan. 27 2014 4:25 PM

The End of the Beginning on Obamacare Repeal

179564766-sen-richard-burr-arrives-at-a-senate-select
Sen. Richard Burr

Photo by Mark Wilson/Getty Images

Sens. Tom Coburn, Richard Burr, and Orrin Hatch rolled out an Obamacare replacement plan today that I think offers us a good window into how the health care debate is evolving on Capitol Hill. I recommend Philip Klein's rundown in the Washington Examiner for a clear description of the details, but the view from 50,000 feet is basically that this is the Republican Party stepping away from the idea that it's going to repeal the Affordable Care Act.

Of course, in its official operations the way the bill works is to first repeal Obamacare and then replace it with a new law that happens to retain some of Obamacare's most popular features. For example, "insurers would be barred from imposing lifetime limits on medical claims and required to allow individuals to remain on their parents’ policies until the age of 26." And rather than eliminate the Affordable Care Act's restrictions on insurers charging older people higher premiums than younger people, the senators would simply make the restrictions a bit less strict. And while Coburn/Burr/Hatch don't want to altogether ban insurers from refusing to cover people with pre-existing conditions, they "would require insurers to offer coverage to anybody who has applied as long as they have maintained continuous coverage, regardless of whether they are switching health plans or shifting from employer-based health care to the individual market."

In other words, rather than scrapping the main pillars of the Affordable Care Act entirely, they would partially roll them back.

Advertisement

Conversely, while conservative wonks have traditionally favored a big bang approach to eliminating the massive tax subsidies that keep employer-provided insurance together, "in consideration of the backlash against the way that Obamacare has disrupted people’s insurance coverage, the new GOP proposal would maintain the employer health insurance bias."

Last but by no means least "[i]nstead of expanding Medicaid, as Obamacare does, the Coburn-Burr-Hatch proposal would reform it to give more flexibility to states and allow Medicaid beneficiaries the option of using their tax credit to purchase private coverage."

I don't think the plan as written is fully sound from a structural viewpoint. In particular, the continuous coverage rule is the kind of thing that's easy to write down as a single sentence in a column but difficult to turn into a clear piece of legislation. Turning that into a workable regulation, especially in a world where which insurance plans are available changes from time to time and place to place, would be a whole giant process and you'd have to evaluate a specific proposal. But the key thing about this is that it doesn't envision radically remaking the health care system along free market lines. Relatively to the status quo that existed in 2009, it would constitute modestly remaking the health care system along liberal lines. Most of all, as a political document it reflects an appreciation of the overwhelming political power of the status quo. You can't kick those 25-year-olds off their parents' insurance plan. You can't deny the currently insured the peace-of-mind that comes from knowing that getting sick won't make them uninsurable. You can't change tax policy in a way that's too disruptive. And this plan isn't going to pass in 2014. It's not going to pass in 2015. And it's not going to pass in 2016. By 2017, Medicaid expansion and subsidized exchange plans will be the new status quo. Are the Coburns, Burrs, and Hatches of 2017 really going to be willing to blow that up?

Matthew Yglesias is the executive editor of Vox and author of The Rent Is Too Damn High.

TODAY IN SLATE

Politics

Talking White

Black people’s disdain for “proper English” and academic achievement is a myth.

Hong Kong’s Protesters Are Ridiculously Polite. That’s What Scares Beijing So Much.

The One Fact About Ebola That Should Calm You: It Spreads Slowly

Operation Backbone

How White Boy Rick, a legendary Detroit cocaine dealer, helped the FBI uncover brazen police corruption.

A Jaw-Dropping Political Ad Aimed at Young Women, Apparently

The XX Factor
Oct. 1 2014 4:05 PM Today in GOP Outreach to Women: You Broads Like Wedding Dresses, Right?
Music

How Even an Old Hipster Can Age Gracefully

On their new albums, Leonard Cohen, Robert Plant, and Loudon Wainwright III show three ways.

How Tattoo Parlors Became the Barber Shops of Hipster Neighborhoods

This Gargantuan Wind Farm in Wyoming Would Be the Hoover Dam of the 21st Century

Moneybox
Oct. 1 2014 8:34 AM This Gargantuan Wind Farm in Wyoming Would Be the Hoover Dam of the 21st Century To undertake a massively ambitious energy project, you don’t need the government anymore.
  News & Politics
Politics
Oct. 1 2014 7:26 PM Talking White Black people’s disdain for “proper English” and academic achievement is a myth.
  Business
Moneybox
Oct. 2 2014 9:19 AM Alibaba’s Founder on Why His Company Is Killing It in China
  Life
Quora
Oct. 2 2014 8:27 AM How Do Teachers Kill the Joy of Reading for Students?
  Double X
The XX Factor
Oct. 1 2014 5:11 PM Celebrity Feminist Identification Has Reached Peak Meaninglessness
  Slate Plus
Behind the Scenes
Oct. 1 2014 3:24 PM Revelry (and Business) at Mohonk Photos and highlights from Slate’s annual retreat.
  Arts
Culturebox
Oct. 2 2014 9:08 AM Demons Are Real A horror movie goes behind the scenes on an Intervention-like reality show.
  Technology
Future Tense
Oct. 1 2014 6:59 PM EU’s Next Digital Commissioner Thinks Keeping Nude Celeb Photos in the Cloud Is “Stupid”
  Health & Science
Bad Astronomy
Oct. 2 2014 7:30 AM What Put the Man in the Moon in the Moon?
  Sports
Sports Nut
Oct. 1 2014 5:19 PM Bunt-a-Palooza! How bad was the Kansas City Royals’ bunt-all-the-time strategy in the American League wild-card game?